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Effects of sleep disturbance on dyspnoea and impaired lung function following hospital admission due to COVID-19 in the UK: a prospective multicentre cohort study
Callum Jackson,
Iain D Stewart,
Tatiana Plekhanova,
Peter S Cunningham,
Andrew L Hazel,
Bashar Al-Sheklly,
Raminder Aul,
Charlotte E Bolton,
Trudie Chalder,
James D Chalmers,
Nazia Chaudhuri,
Annemarie B Docherty,
Gavin Donaldson,
Charlotte L Edwardson,
Omer Elneima,
Neil J Greening,
Neil A Hanley,
Victoria C Harris,
Ewen M Harrison,
Ling-Pei Ho,
Linzy Houchen-Wolloff,
Luke S Howard,
Caroline J Jolley,
Mark G Jones,
Olivia C Leavy,
Keir Lewis ,
Nazir I Lone,
Michael Marks,
Hamish J C McAuley,
Melitta McNarry ,
Brijesh V Patel,
Karen Piper-Hanley,
Krisnah Poinasamy,
Betty Raman,
Matthew Richardson,
Pilar Rivera-Ortega,
Sarah L Rowland-Jones,
Alex V Rowlands,
Ruth M Saunders,
Janet T Scott,
Marco Sereno,
Ajay M Shah,
Aarti Shikotra,
Amisha Singapuri,
Stefan C Stanel,
Mathew Thorpe,
Daniel G Wootton,
Thomas Yates,
R Gisli Jenkins,
Sally J Singh,
William D-C Man,
Christopher E Brightling,
Louise V Wain,
Joanna C Porter,
A A Roger Thompson,
Alex Horsley,
Philip L Molyneaux,
Rachael A Evans,
Samuel E Jones,
Martin K Rutter,
John F Blaikley,
C Jackson,
I D Stewart,
T Plekhanova,
P S Cunningham,
A L Hazel,
B Al-Sheklly,
R Aul,
C E Bolton,
T Chalder,
J D Chalmers,
N Chaudhuri,
A B Docherty,
G Donaldson,
C L Edwardson,
O Elneima,
N J Greening,
N A Hanley,
V C Harris,
E M Harrison,
L-P Ho,
L Houchen-Wolloff,
L S Howard,
C J Jolley,
M G Jones,
O C Leavy,
K E Lewis,
N I Lone,
M Marks,
H J C McAuley,
M A McNarry,
B Patel,
K Piper-Hanley,
K Poinasamy,
B Raman,
M Richardson,
P Rivera-Ortega,
S L Rowland-Jones,
A V Rowlands,
R M Saunders,
J T Scott,
M Sereno,
A M Shah,
A Shikotra,
A Singapuri,
S C Stanel,
M Thorpe,
D G Wootton,
T Yates,
G Jenkins,
S J Singh,
W D-C Man,
C E Brightling,
L V Wain,
J C Porter,
R Thompson,
A Horsley,
P L Molyneaux,
R A Evans,
S E Jones,
M K Rutter,
J F Blaikley,
K Abel,
H Adamali,
D Adeloye,
O Adeyemi,
R Adrego,
L A Aguilar Jimenez,
S Ahmad,
N Ahmad Haider,
R Ahmed,
N Ahwireng,
M Ainsworth,
B Al-Sheklly,
A Alamoudi,
M Ali,
M Aljaroof,
AM All,
L Allan,
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P Almeida,
D Altmann,
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The Lancet Respiratory Medicine
Swansea University Authors: Keir Lewis , Melitta McNarry
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DOI (Published version): 10.1016/s2213-2600(23)00124-8
Abstract
Background Sleep disturbance is common following hospitalisation both for COVID-19 and other causes. The clinical associations are poorly understood despite sleep disturbance contributing to morbidity in other scenarios. Therefore, we investigated the prevalence and nature of sleep disturbance after...
Published in: | The Lancet Respiratory Medicine |
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ISSN: | 2213-2600 |
Published: |
Elsevier BV
2023
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URI: | https://cronfa.swan.ac.uk/Record/cronfa63255 |
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Abstract: |
Background Sleep disturbance is common following hospitalisation both for COVID-19 and other causes. The clinical associations are poorly understood despite sleep disturbance contributing to morbidity in other scenarios. Therefore, we investigated the prevalence and nature of sleep disturbance after COVID-19 hospitalisation and whether this was associated with dyspnoea. MethodsSleep parameters were assessed in a prospective multi-centre cohort of patients (n=2,468) hospitalised for COVID-19 in the United Kingdom using both subjective (n=638) and device-based (n=729) measures. Results were compared to a matched UK Biobank cohort. Multivariable linear regression was used to define associations. FindingsThe majority (62% (396/638)) of participants reported poor sleep quality. A comparable proportion (53% (338/638)) felt their sleep quality had deteriorated for at least 1-year following hospitalisation. Compared to a non-hospitalised matched cohort, both sleep regularity (44·5 vs 56·5) and sleep efficiency (85·4% vs 89·0%) were lower as opposed to sleep period duration which was longer (8·25h vs 7·17h). Overall sleep quality (effect estimate 3·9, 95%CI (2·8–5·1)), deterioration in sleep quality following hospitalisation (effect estimate 3·0, 95%CI (1·8–4·3)), and sleep regularity (effect estimate 4·4, 95%CI (2·1–6·7)) were associated with dyspnoea and impaired lung function (FEV1 and FVC). Depending on the sleep metric, anxiety mediated 18–39% of the effect of sleep disturbance on dyspnoea and muscle weakness mediated 27-41% of this effect.InterpretationSleep disturbance is associated with dyspnoea, anxiety, and muscle weakness following COVID-19 hospitalisation. Targeting sleep disturbance may be beneficial in treating the post-COVID-19 condition. |
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Faculty of Science and Engineering |
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CJ is funded by an Engineering and Physical Sciences Research Council (EPSRC) Mathematics Doctoral Training Partnership (EP/W523884/1). L-PH is supported in part by the Oxford NIHR Biomedical Research Centre. PLM is supported by an Action for Pulmonary Fibrosis Mike Bray Fellowship and an Asthma + Lung UK Chair in Respiratory Research. KP-H receives funding from Innovate UK (TS/T013028/1) and the UK Medical Research Council (MRC; MR/W006111/1). JCP receives funding from the NIHR University College London Hospitals Biomedical research centre and Breathing Matters charity. BR is funded by the British Heart Foundation Oxford Centre of Research Excellence (RE/18/3/34214). ABD is funded by a Wellcome fellowship (216606/Z/19/Z). AART is supported by a British Heart Foundation intermediate clinical fellowship (FS/18/13/33281). LVW is supported by the GlaxoSmithKline/Asthma + Lung UK Chair in Respiratory Research (C17-1). DGW is funded by an NIHR Advanced Fellowship (NIHR300669). RGJ is supported by a NIHR Research Professorship (RP-2017-08-ST2-014). JFB and PSC are supported by an MRC transition support fellowship (MR/T032529/1). IDS is supported by a fellowship funded by The Rayne Foundation. The work was also supported by an Asthma + Lung UK Malcolm Walleans Grant. This work was supported by the NIHR Manchester Biomedical Research Centre (grant number NIHR203308; JFB, MKR, and AH). The study was also funded by UK Research and Innovation and National Institute of Health Research (grant references: EP/V051490/1, MR/V027859/1, MR/W006111/1, and COV0319). PHOSP-COVID is jointly funded by a grant from the MRC-UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research (NIHR) rapid response panel to tackle COVID-19 grant references above. |